Insurance certification 2026

1. Click ‘Get Form’ to open the insurance certification in the editor.
2. Begin by entering the locality where your business license is issued, including the city or town name.
3. Fill in your business or trade name along with the business license number. Ensure all information is complete and legible.
4. Provide the name of the business owner or contractor, including their home mailing address and telephone number.
5. If applicable, enter your business's Federal Employer ID (FEIN) or Tax ID Number. If you are a sole proprietor without a FEIN, list your social security number.
6. Indicate whether you have workers' compensation insurance by checking the appropriate box and providing details about your insurance carrier.
7. If you do not have workers' compensation insurance, answer the questions regarding employee count and subcontractors.
8. Finally, ensure that you sign and date the form, printing your name clearly beneath your signature before submitting it to the licensing authority.

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